Provider Demographics
NPI:1013151604
Name:APEX HEART CARE, PLLC
Entity Type:Organization
Organization Name:APEX HEART CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:B
Authorized Official - Last Name:LICHT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-300-2793
Mailing Address - Street 1:8259 N 1ST DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5569
Mailing Address - Country:US
Mailing Address - Phone:602-300-2793
Mailing Address - Fax:
Practice Address - Street 1:3440 W CACTUS RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-2238
Practice Address - Country:US
Practice Address - Phone:602-956-2141
Practice Address - Fax:602-956-2725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ151994Medicaid
AZZ24448Medicare PIN
AZ151994Medicaid